BERLIN — The World Health Summit, held annually in Berlin, has developed a reputation for big-picture agenda setting, rallying support for the 2030 Agenda for health and campaigning for technological innovations in the field. This year’s goals will be slightly more ambitious.
The 2020 edition of the gathering — which began virtually on Sunday after plans for a hybrid online and in-person event were scrapped last minute — aims to build an international consensus on a way through the COVID-19 pandemic, while taking stock of the damage the coronavirus has done to global health initiatives, and underscoring the importance of restoring these efforts.
“This year is different because the situation is different,” Detlev Ganten, the founding president of WHS, told Devex. “It shows how important health is. Health is more than medicine, it is more than basic research. It is the essence of a functional society.”
There are some concerns, though, about whose perspectives are shaping that consensus, with the voices of community organizers largely missing from the program.
“This is the first major health conference in the COVID atmosphere,” Lois Chingandu, a Zimbabwean HIV specialist and a director at Frontline AIDS, told Devex. “There was an expectation that for a platform of this nature, the world would find it important to bring community representatives to hear what the realities of communities are and to make them part of the decision-making process.”
Building global systems
This year’s summit is built around several themes, including the connection between climate change and health, but the overriding goal is achieving, or restoring, the consensus around global health priorities that has been strained by the pandemic.
One of the easier points of agreement has been the need to improve cross-border pandemic preparedness efforts, including the prevention and treatment of infectious diseases.
Where governments initially retreated to nationalized responses, and countries including the United States and China continue to chafe under the leadership of globally minded organizations, Andrew Witty, the co-lead of the World Health Organization’s COVID-19 vaccine program, said the pandemic has reinforced just how interlinked health really is.
“What we’ve learned over the last seven or eight months is that the virus pays no respect to borders, geography, politics,” he said during an early WHS panel. “We need to shift the global mindset to global threats. Rather than wait seven or eight months for countries to learn they’re not special, this encourages us to be really humbled by what this virus has done to us and to respond assertively to that.”
There is an opportunity to build on that understanding to create truly global systems for disease prevention and treatment. That includes a clear need to reinforce multilateral cooperation around issues such as vaccine research and access, Ganten said, underscored by the debates already swirling around access to a potential COVID-19 vaccine.
“We need health systems that work, before we face an outbreak of something more contagious than COVID-19, more deadly, or both.”— António Guterres, secretary-general, United Nations
WHS also offers an opportunity to restore attention to health priorities that have been sidelined during the pandemic, some delegates said, including vaccination campaigns and efforts to address noncommunicable diseases and neglected tropical diseases.
A WHO rapid assessment in May found that 75% of countries had reported interruptions in their NCD services.
Heron Holloway, communications specialist with the Defeat-NCD Partnership, told Devex that instead of allowing the pandemic to further undermine efforts to combat NCDs, leaders should take the opportunity to refocus — particularly as evidence mounts that underlying NCDs increase the risk of a severe COVID-19 infection.
“There is lots of money allocated for COVID-19 responses that are bolstering health systems, doing more screening, building laboratory capacities,” she said. “You could easily add an NCD piece to that.” WHS and other global forums offer an opportunity to share strategies for leveraging the pandemic funding to pursue a more holistic response.
The biggest hurdle might be restoring attention to the kind of big-picture frameworks — the Sustainable Development Goals and universal health coverage — that are designed to prepare health systems to prevent and withstand all these challenges.
Given their scale, these initiatives require a longer-term perspective that is difficult to realize in the midst of a pandemic. But United Nations Secretary-General António Guterres used his opening address to emphasize the necessity of achieving these goals — and fast.
“Universal health coverage is the path to high-quality, equitable, affordable health care,” he said. All U.N. member states have committed to attempting to achieve UHC by 2030, “but we cannot wait 10 years,” he said. “We need health systems that work, before we face an outbreak of something more contagious than COVID-19, more deadly, or both.”
Chingandu wants to make sure that everyone is involved in refocusing and accelerating that agenda. While WHS has drawn experts from health ministries, pharmaceutical companies, and universities around the world, she pointed to a lack of voices from organizations rooted in communities. Only a handful of speakers are from community-based groups and just a fraction of those are from the global south.
“It is a way of saying to the community, when it comes to health issues, it’s a specialized area,” she said. “We’ll call doctors, call ministers to discuss these issues and to make important decisions,” even as the pandemic has revealed the importance of community-based organizations.
That includes community groups’ ability to anticipate potential problems in interventions, including how lockdowns might affect access to vital services such as antenatal care for pregnant women, for example, and to shore up the response to COVID-19 where international NGOs withdrew.
Though community groups aren’t on the list of speakers, their importance was recognized in a Sunday discussion about the role of partnerships in improving health outcomes. Shannon Hader, deputy director at UNAIDS and one of the panelists, said community-led groups have led some of the most important responses to the pandemic and point a way to restoring the global health agenda.
“What’s needed to see more of those successes?” she asked. “Political leadership that can be transformative when it works to eliminate barriers to community response.”